Multiple Cardiac Metastases from a Nonfunctioning Pancreatic Neuroendocrine Tumor

Choi, Yong Hyeok; Han, Hye‐Suk; Lim, Sung Cil; Lee, Sang Yeub; Koo, Ji Hae; Lee, Ok-Jun; Lee, Ki Hyeong; Kim, Seung Taik

doi:10.4143/crt.2013.45.2.150

Cited by 9 publications

(11 citation statements)

References 13 publications

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“…Only one case of a PNEN patient with cardiac metastasis has been described to date [14]. In contrast to that patient, ours received successful postoperative treatment due to cardiac metastasis.…”

Section: Opis Przypadkumentioning

confidence: 71%

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Nietypowy przypadek przebiegu nowotworu neuroendokrynnego trzustki pod postacią przerzutu do serca — opis przypadku klinicznego

Boratyn-Nowicka

Blicharz-Dorniak

Wachuła

et al. 2014

Endokrynologia Polska

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An atypical course of pancreatic neuroendocrine tumour manifesting as cardiac metastasis -a clinical caseNietypowy przypadek przebiegu nowotworu neuroendokrynnego trzustki pod postacią przerzutu do serca -opis przypadku klinicznego AbstractThis paper presents a ten-year course of the disease in a patient with pancreatic neuroendocrine tumour NEN G1, and with confirmed single, asymptomatic metastasis to the left cardiac ventricle. Initially, the cardiac metastasis was visible only on a positron emission tomography (PET) scan using gallium-68-labelled somatostatin analogue; the sensitivity of an echocardiography scan was lower. Despite the advanced stage of the disease, surgical excision of the cardiac metastasis was performed. The patient underwent a total of eight operations, and received chemotherapy, radiotherapy and somatostatin analogues. Currently, he is on a targeted therapy with everolimus. As a result of the treatment, the patient remains in a good general condition. This is the second described case of cardiac metastasis of PNEN. StreszczenieW pracy przedstawiono 10-letni przebieg choroby u pacjenta z nowotworem neuroendokrynnym trzustki NEN G1, u którego stwierdzono pojedynczy, bezobjawowy przerzut do lewej komory serca. Przerzut do serca widoczny był początkowo jedynie w badaniu pozytronowej tomografii emisyjnej z użyciem analogu somatostatyny znakowanej galem-68 , czułość badania echokardiograficznego była mniejsza. Pomimo zaawansowanej choroby wykonano operacyjne usunięcie przerzutu z serca. W sumie chory był 8-krotnie operowany, otrzymywał chemioterapię, radioterapię oraz analogii somatostatyny, a obecnie prowadzona jest terapia celowana everolimusem. W wyniku zastosowanego leczenia chory pozostaje w dobrym stanie ogólnym. Jest to drugi opisany przypadek z przerzutem PNEN do serca. Stosowanie różnych metod leczenia w przypadku uogólnionego nowotworu neuroendokrynnego trzustki o niskim potencjale proliferacyjnym daje szansę na wydłużenie przeżycia przy zachowaniu dobrej jakości życia.

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Section: Opis Przypadkumentioning

confidence: 71%

“…Cardiac metastases in PNENs are case-based reasoning. To date, one case has been published concerning a patient diagnosed with PNEN G2, with multiple synchronous metastases to the lymph nodes, bones and the heart found upon diagnosis [14].…”

Section: Opis Przypadkumentioning

confidence: 99%

Nietypowy przypadek przebiegu nowotworu neuroendokrynnego trzustki pod postacią przerzutu do serca — opis przypadku klinicznego

Boratyn-Nowicka

Blicharz-Dorniak

Wachuła

et al. 2014

Endokrynologia Polska

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“…Functioning neuroendocrine tumors often release various vasoactive substances (serotonin, histamine, and bradykinin). Typical presentation includes flushing, wheezing, and diarrhea [ 3 ]. Heart failure in a patient with functioning NET is due to associated carcinoid heart disease.…”

Section: Discussionmentioning

confidence: 99%

“…This includes intracardiac tumors causing conduction deficits and cardiac arrhythmias. Pericardial involvement can lead to inflammation and effusion of the pericardium [ 3 ]. In our case, a large tumor within the right ventricle caused outflow obstruction, leading to congestive heart failure.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Outflow Obstruction Due to Metastatic Neuroendocrine Tumor

Sood

Chiadika

Everett

et al. 2018

Cureus

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Neuroendocrine tumors (NETs) are rare malignant tumors that arise from neuroendocrine cells of the gastrointestinal tract and often metastasize to the liver, lung, and bone. Cardiac metastasis of NETs is uncommon. We report a patient with a past medical history of a neuroendocrine tumor of the left femur presenting with signs and symptoms of new onset heart failure. Transthoracic echocardiogram and cardiac magnetic resonance showed a large mass within the right ventricle causing right ventricular outflow obstruction. A positron emission tomographic/computed tomographic scan (PET-CT) revealed increased uptake of fluorodeoxyglucose (FDG) activity within the right ventricle consistent with metastasis. Cardiac biopsy of the right ventricular mass revealed metastatic nonfunctioning neuroendocrine tumor. In view of the fact that it was a tumor that caused the right ventricular obstruction, the patient was started on chemotherapy with improvement of symptoms. This case highlights that in patients with a history of neuroendocrine tumor presenting with heart failure, cardiac metastasis should be included in the differential.

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“…Multiple malignancies have demonstrated the ability to metastasize to cardiac tissue. While this metastatic course is uncommon, the incidence has increased over the last decade due to improved survival rates among cancer patients [1]. In postmortem evaluations, cardiac metastasis has been reported to occur in up to 9.1% of patients with advanced cancers [2].…”

Section: Introductionmentioning

confidence: 99%

A Multimodal Approach to Evaluate for Cardiac Metastasis in a Case of Non-Small Cell Lung Cancer

et al. 2020

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Malignancies have demonstrated the ability to metastasize to cardiac tissue. However, an optimal diagnostic algorithm for cardiac tumors has not yet been established, due at least in part to the scarcity of symptomatic cases. Several case reports describe how the usage of 18 F-labeled fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) incidentally revealed cardiac neoplasia. This modality, which indicates uptake sites of the radioisotope 18 F-FDG, allows for whole-body imaging and is often used for preoperative determination of malignant metastasis or for assessing response to therapy over time. However, findings of false positivity are often reported due to increased FDG avidity caused by a range of other, nonmetastatic processes, most notably inflammation and infection. In this case report, an 84-year-old male with stage IV non-small cell lung cancer presented a clinical course, echocardiogram, and 18 F-FDG PET-CT findings that were suggestive of endocardial metastasis. Nine months into therapy, after extensive consultation, the patient finally consented to a more complete workup using cardiac MRI (CMRI), which showed no evidence of cardiac metastasis. This case report supports the utility of CMRI as a means of further interpreting intracardiac, localized FDG uptake foci in PET-CT findings, in order to avoid false positivity and further refine proposed cardiac differential diagnoses in cancer patients.

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Multiple Cardiac Metastases from a Nonfunctioning Pancreatic Neuroendocrine Tumor

Cited by 9 publications

References 13 publications

Nietypowy przypadek przebiegu nowotworu neuroendokrynnego trzustki pod postacią przerzutu do serca — opis przypadku klinicznego

Nietypowy przypadek przebiegu nowotworu neuroendokrynnego trzustki pod postacią przerzutu do serca — opis przypadku klinicznego

Right Ventricular Outflow Obstruction Due to Metastatic Neuroendocrine Tumor

A Multimodal Approach to Evaluate for Cardiac Metastasis in a Case of Non-Small Cell Lung Cancer

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